title: Surgical repair of a 30 mm long human median nerve defect in the distal forearm by implantation of a chitosan-PGA nerve guidance conduit.
abstract: This paper describes a clinical case study in which a chitosan/polyglycolic acid nerve guidance conduit (chitosan-PGA NGC) was utilized to repair a 30 mm long median nerve defect in the right distal forearm of a 55 year-old male patient. Thirty-six months after the nerve repair, the palm abduction of the thumb and the thumb-index digital opposition recovered, facilitating the patient to accomplish fine activities, such as handling chopsticks. Static two-point discrimination measured 14, 9 and 9 mm in the thumb, index and middle fingers of the right hand. Reproducible compound muscle action potentials were recorded on the right abductor pollicis. The ninhydrin test, a classical method for assessing sympathetic nerve function, showed partial recovery of the perspiration function of the injured thumb, index and middle fingers. This repair case suggested a possible strategy for the clinical reconstruction of extended defects in human peripheral nerve trunks by the implantation of chitosan-PGA NGCs.
authors.affiliation: Jiangsu Key Laboratory of Neuroregeneration and Department of Hand Surgery, Nantong University, 19 Qixiu Road, Nantong, JS 226001, People's Republic of China.
authors.forename: Jianhui
authors.initials: J
authors.lastname: Gu
authors.forename: Wen
authors.initials: W
authors.lastname: Hu
authors.forename: Aidong
authors.initials: A
authors.lastname: Deng
authors.forename: Qing
authors.initials: Q
authors.lastname: Zhao
authors.forename: Shibi
authors.initials: S
authors.lastname: Lu
authors.forename: Xiaosong
authors.initials: X
authors.lastname: Gu
mesh_terms: D000200:Action Potentials / Q000187:drug effects; D000596:Amino Acids / Q000378:metabolism; D048271:Chitosan / Q000494:pharmacology*; D005542:Forearm / Q000294:innervation* / Q000473:pathology / Q000503:physiopathology; D048091:Guided Tissue Regeneration / Q000379:methods*; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000187:drug effects / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D009132:Muscles / Q000187:drug effects / Q000503:physiopathology; D009555:Ninhydrin / Q000378:metabolism; D011100:Polyglycolic Acid / Q000494:pharmacology*; D019919:Prosthesis Implantation; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function / Q000187:drug effects; D014945:Wound Healing / Q000187:drug effects
chemical_list: D000596:Amino Acids; D011100:Polyglycolic Acid; D048271:Chitosan; D009555:Ninhydrin